Provider Demographics
NPI:1093141426
Name:STRAKER, CHRISTINA MARIE (LMP)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:STRAKER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:AUTUMN
Other - Middle Name:CHRISTINA-MARIE
Other - Last Name:STRAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP
Mailing Address - Street 1:8105 GREENWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4230
Mailing Address - Country:US
Mailing Address - Phone:206-407-8099
Mailing Address - Fax:
Practice Address - Street 1:8105 GREENWOOD AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4230
Practice Address - Country:US
Practice Address - Phone:206-407-8099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60395014225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist